Methods for promoting functional regeneration of mammalian muscle by administering leukaemia inhibitor factor

ABSTRACT

The present invention relates to a method for regulating neuron development, maintenance and regeneration in the central and peripheral nervous systems of a mammal and to pharmaceutical compositions comprising leukaemia inhibitory factor with or without nerve growth factor useful for same. The present invention is particularly useful in the treatment of developmental and cerebral anomalies and neuropathies in mammals and in particular humans.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation in part of Ser. No. 07/923,939 filed Nov. 19, 1992, now abandoned, which is a national stage filing of PCT AU 91/00103 filed Mar. 20, 1991 which claims foreign priority to Australian Patent Application No. PJ9205 which was filed Mar. 20, 1990.

FIELD OF THE INVENTION

The present invention relates to a method for regulating neuron development, maintenance and regeneration in the central and peripheral nervous systems of a mammal and to pharmaceutical compositions comprising leukaemia inhibitory factor or leukaemia inhibitory factor in combination with nerve growth factor useful for same. The present invention is particularly useful in the treatment of developmental and cerebral anomalies and neuropathies in mammals and in particular humans.

Leukaemia Inhibitory Factor (hereinafter referred to as "LIF") is a protein that has been purified, cloned and produced in large quantities in purified recombinant form from both Escherichia coli and yeast cells (international Patent Application PCT/AU88/00093). LIF was originally isolated on the basis its capacity to induce differentiation and suppression of the murine myeloid leukaemic cell line, M1.

The present invention arose in part from an investigation of the effects of LIF on cells of the neural crest. The neural crest is a population of precursor cells which arises from the dorsal lip of the neural tube during embryogenesis and migrates through the embryo along a complex series of pathways. After migration, the crest cells give rise to a great variety of cell types including the neurons and Schwann cells of the sensory and autonomic ganglia, the enteric nervous system, adrenal medulla, melanocytes of the skin and facial mesenchyme. When studied at the population level, the crest appears to be a multipotent collection of stem cells. The extensive transplantation experiments of Le Douarin and colleagues, whereby quail neural crest were grafted into chick embryos, showed that the developmental fate of the crest cells was determined by the location of this graft in the chick embryo (1). This not only indicated that the full developmental repertoire of the crest is contained in the different subpopulations of grafted crest cells, but also that environmental factors play a major role in the final differentiated phenotype of the cells.

In the last decade, it has become increasingly clear that the neural crest contains subpopulations of cells which are already committed to particular developmental pathways (2,3). However, it is also clear that the differentiation of these cells is determined by environmental factors.

A number of soluble trophic factors have been shown to act as survival agents for neural crest derived neurons, but none of these have been shown to act directly on the neuronal precursor cells within the neural crest. These factors include nerve growth factor (NGF; 4), brain-derived neurotrophic factor (BDNF; 5), ciliary neurotrophic factor (CNTF; 6) and the fibroblast growth factors (FGF's; see 5). In work leading up to the present invention, experiments were conducted to locate an agent or a combination of agents having direct effect on the precursor populations of the neural crest. In accordance with the present invention, it has been surprisingly discovered that neural crest cells differentiate into fully mature neurons in the presence of LIF. This effect is titratable and occurs in the absence of proliferation of neuronal precursor cells. Furthermore, the effect of LIF on the differentiation of neural crest cells into neurons extends to the stimulation of the differentiation of precursor cells in embryonic dorsal root ganglia (DRG) into mature sensory neurons. It has further been discovered in accordance with the present invention, that there is a synergistic interaction between LIF and nerve growth factor (hereinafter referred to as "NGF") in the development of neurons.

SUMMARY OF THE INVENTION

One aspect of the present invention contemplates a method for regulating neuron development and/or maintenance and/or regeneration in a mammal comprising administering to said mammal an effective amount of leukaemia inhibitory factor (LIF) for a time and under conditions sufficient to permit the differentiation and/or maintenance and/or regeneration of neural precursor cells into neurons.

Another aspect of the present invention contemplates a method for regulating neuron development and/or maintenance and/or regeneration in a mammal comprising the sequential or simultaneous administration to said mammal of respective effective amounts of LIF and NGF for a time and under conditions sufficient to permit the differentiation and/or regeneration of neural precursor cells into neurons and/or mainenance of said neurons.

Yet another aspect of the present invention relates to a method for enhancing and/or stimulating and/or maintaining and/or regenerating the formation and/or survival of neurons in the central nervous system of a mammal which comprises administering to said mammal an effective amount of LIF for a time and under conditions sufficient to effect an increase in and/or to maintain the number of neurons in the central nervous system.

Still another aspect of the present invention is directed to a method for enhancing and/or stimulating and/or maintaining and/or regenerating the formation and/or survival of neurons in the central nervous system of a mammal which comprises the sequential or simultaneous administration to said mammal of respective effective amounts of LIF and NGF for a time and under conditions sufficient to effect an increase in and/or to maintain the number of neurons in the central nervous system.

In yet another aspect of the present invention, there is provided a method for enhancing, stimulating and/or maintaining the formation and/or survival of neurons, for example sensory neurons, of the peripheral nervous system of a mammal which comprises administering to said mammal an effective amount of LIF for a time and under conditions sufficient to effect an increase in and/or to maintain the number of neurons in the peripheral nervous system.

In still yet another aspect of the present invention, there is contemplated a method for enhancing, stimulating and/or maintaining the formation and/or survival of neurons, for example, sensory neurons of the peripheral nervous system of a mammal which comprises the sequential or simultaneous administration to said mammal of respective effective amounts of LIF and NGF for a time and under conditions sufficient to effect an increase in and/or to maintain the number of neurons in the peripheral nervous system.

Another aspect of the present invention contemplates a pharmaceutical composition comprising LIF and NGF and one or more pharmaceutically acceptable carriers and/or diluents.

Yet a further aspect of the present invention is directed to the use of LIF or LIF and NGF in the manufacture of a medicament for enhancing, stimulating, maintaining and/or regenerating neurons in a mammal.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a graphical representation showing the effect of LIF on neuron numbers in neural crest cultures. Neural crest cells were incubated in medium alone or in the presence of LIF for 6 days, Nissl stained (8), and neurons were counted using bright field microscopy. In the "- tube" experiment, neural tubes were removed after 24 h and LIF was added to the cultures. Neuron numbers could not be accurately counted at later times because of dense clustering of neurons in LIF cultures. Numbers are the mean and standard deviation, n=6. *P<0.005, **P<0.05; t-test.

FIG. 2(a) is a photograph showing the phenotype of neurons in neural crest cultures incubated for 13 days in the absence of LIF. Photomicrograph shown in a bright field view of Nissl stained (8) cultures. (bar=200 μm).

FIG. 2(b) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a bright field view of Nissl stained (8) cultures. (bar=200 μm).

FIG. 2(c) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a fluorescence view of cultures stained for neural filament. (bar=50 μm).

FIG. 2(d) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a fluorescence view of cultures stained for neural filament. (bar=50 μm).

FIG. 2(e) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a bright field view of LIF treated culture stained for CGRP. (bar=50 μm).

FIG. 2(f) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a bright field view of LIF treated culture stained for tyrosine hydroxylase. (bar=50 μm).

FIG. 2(g) is a photograph showing the phenotype of neurons in neural crest cultures. Neural crest cultures were incubated for 13 days in the presence of LIF. Photomicrograph shown is a fluorescence view of the same field as in FIG. 2(f). (bar=50 μm).

FIG. 3(a) is a bright field photomicrographic representation showing ³ H-thymidine incorporation into neural crest cultures. ³ H-thymidine (0.03 μC/ml) and LIF (10⁴ U/ml) were added after 4 days of culture and incubation continued for another 9 days, following which cultures were stained for neurofilament and autoradiographed (9). (bar=50 μm).

FIG. 3(b) is a fluorescence view of the bright field photomicrograph of FIG. 3(a). (bar=50 μm).

FIG. 4(a) is a graphical representations showing the effect of LIF on neuron numbers in cultures of E12-P2 DRG. DRG cells were plated in Monomed medium, 10% FBS (control, black bars) or +LIF (10⁴ U/ml, hatched bars) and neuron numbers determined after 5 days (E12) or 2 days (other cultures) as described in Example 1. Numbers of neurons and cells initially plated are given in Example 1. (n=6).

FIG. 4(b) is a graphical representation showing limit dilution analysis of neuron survival in P2 DRG cultures. Cells (70% neurons, of which 75% plated after 2 hrs) were plated at the indicated number (120 wells/dilution) in the presence (diamonds) or absence (squares) or 10² U/ml LIF and wells with live neurons were counted after 2 days. A linear relationship exists between input cells number and the log of the % negative wells (R=0.992), indicating that the effect of LIF on neuron survival obeys zero order (single hit) kinetics (11). (n=6).

FIG. 4(c) is a graphical representation showing dose-response relationship of neurons to LIF concentration in P2 DRG cultures. P2 DRG cells (200/well) were plated with the indicated concentration of LIF and neurons were counted after 2 days. Mean and standard deviation are shown in FIG. 4(a) and FIG. 4(c), (n=6).

FIG. 5(a) is a photographic representation showing photomicrographs of explants of E10 spinal cords cultured in the presence of LIF in 24 well plates at D7 in vitro to display process outgrowth. (bar=100 μm).

FIG. 5(b) is a photographic representation showing photomicrographs of explants of E10 spinal cords cultured in the presence of LIF in 24 well plates at D7 in vitro to display process outgrowth. (bar=100 μm).

FIG. 6(a) is a photographic representations showing the morphology of cultures arising from LIF stimulated spinal cord cells. Cells in suspension were plated as described in Example 1 and incubated in 96 well plates for 5 days. FIG. 6(a) depicts phase-contrast photo photographs of cells incubated with no LIF. (bar=100 μm).

FIG. 6(b) is a photographic representations showing the morphology of cultures arising from LIF stimulated spinal cord cells. Cells in suspension were plated as described in Example 1 and incubated in 96 well plates for 5 days. FIG. 6(b) depicts phase-contrast photo photographs of cells incubated with LIF. (bar=100μ).

FIGS. 6c,d are photographic representations showing cultures of spinal cord precursors stained for neurofilament antibody. Cells were plated as described in Example 1 and incubated in HL-A plates for 5 days prior to fixation and staining. Shown are fluorescence photomicrographs of cells incubated with c) no LIF d) LIF (Bar=100 um).

FIG. 7 is a graphical representation showing the effect of LIF on process outgrowth. E10 spinal cord precursors (5×10⁴) were plated in the presence or absence of LIF (10⁴ U/ml) in 96 well plates for 5 days, as described in materials and methods. The number of processes emanating from each discrete clump of cells to aggregate, was quantitated. The frequency of clumps with a given number of processes was determined. The frequencies for every 5 increments of processes/clump (e.g. 0-5, 5-9) were aggregated and expressed as a % of the total number of clumps per well. These frequencies were averaged for six wells in both LIF treated and control cultures and the means and standard deviations are expressed in the graph.

FIG. 8(a) is a graphical representation showing binding of ¹²⁵ I-LIF to sensory neurons from dorsal root ganglion. FIG. 8(a) depicts minimal binding (solid bars) to accessory cells. Virtually all the binding is inhibitible by cold LIF (hatched bars) indicating that binding is specific.

FIG. 8(b) is a graphical representation showing binding of ¹²⁵ I-LIF to sensory neurons from dorsal root ganglion. Binding (solid bars) is almost exclusively restricted to neurons and not accessory cells (FIG. 8(a)). Virtually all the binding is inhibitible by cold LIF (hatched bars) indicating that binding is specific.

FIG. 9 is a graphical representation showing retrograde Transport of ¹²⁵ I-LIF by sciatic nerve in the adult mouse. Significant accumulation is found in L3, L4, L5 dorsal root ganglia when injections are made into the foot pad (solid bars).

FIG. 10 is a graphical representation showing retrograde transport of ¹²⁵ I-LIF to the sensory ganglia in the newborn mouse. Significant accumulation of label again centred on L4 although this occurred with both foot and muscle injection. There was some uptake by more rostral sensory ganglia when injections were made intra-muscularly.

FIGS. 11(a) (1) and (2) are photographical representation showing an autoradiograph of section through L4 dorsal root ganglia showing accumulation of silver grains over a small population of neurons. Magnification is ×400. Note that only the neurons label, not the Schwann cells (accessory cells). Sections stained with haematoxylin and eosin.

FIGS. 11(b) (1) and (2) are photographical representation showing an autoradiograph of a section through L4 dorsal root ganglia showing accumulation of silver grains over a small population of neurons. Magnification is ×1000. Note that only the neurons label, not the Schwann cells (accessory cells). Sections stained with haematoxylin and eosin.

FIG. 12 is a photographic representation showing the distribution of grain counts in sections of L4 dorsal root ganglia after retrograde labelling with ¹²⁵ I-LIF. Note only a small proportion (5-10%) have significantly labelling.

FIG. 13 is a graphical representation showing spinal cord cells surviving in vitro with and without LIF over time.

FIG. 14 is a graphical representation showing the effects of LIF and NGF on the appearance of neurons in early DRG cultures. DRG cells were plated at 1000 cells/well as described in Example 1 in the presence of LIF and/or NGF and the number of morphologically mature neurons were determined after 4 days. The control contained no added factors. ##STR1##

FIG. 15 is a graphical representation showing a time course of the development of morphologically mature neurons in cultures of E12 DRG cultures. DRG cells from E12 embryos were plated at 300 cells/well in the presence of different factors or NGF antibodies. The number of morphologically mature neurons were determined 2 hr and then every 24 after plating. Particular growth factor additions are as indicated below: ##STR2##

FIG. 16 is a graphical representation depicting a time course of the appearance of neurofilament positive (NF+) cells in E12 DRG cultures. E12 DRG cells were plated as above and after 2 hr and then every 24 hr cultures were fixed and stained for the presence of NF and with detection using immunofluorescence as described in Example 1. Culture conditions are as in FIG. 15. ##STR3##

FIG. 17 is a graphical representation showing the effect of LIF, NGF and anti-NGF on the generation of neurons in neural crest cultures. Neural crest cultures were incubated in the presence of particular growth factors and antibodies as indicated below and stained for the presence of p150 NF at the indicated times. The total number of p150 NF+ neuronal-like cells was determined for each culture and numbers represent mean ± s.d. of four determinations. ##STR4##

FIG. 18(a) is a photographic representation of the appearance of neurons cultured in the presence of LIF or NGF. Photomicrographs show morphologies of neurons which have developed from E12 DRG cultures (1000 cells plated) incubated for 4 days in the presence of LIF+anti-NGF. After culturing, the cultures were fixed and stained for the presence of 150 kd neurofilament with detection using immunoperoxidase as described in Example 1.

FIG. 18(b) is photographic representation of the appearance of neurons cultured in the presence of LIF or NGF. Photomicrographs show morphologies of neurons which have developed from E12 DRG cultures (1000 cells plated) incubated for 4 days in the presence of LIF+NGF. After culturing, the cultures were fixed and stained for the presence of 150 kd neurofilament with detection using immunoperoxidase as described in Example 1.

FIG. 19(a) is a graphical representation depicting the response of differentiated DRG neurons to LIF and NGF through embryonic development. DRG cells from embryos aged E14 to P2 were plated at 300-1000 cells/well and incubated in the presence or absence of growth factors and anti-NGF. The percent neuronal survival was determined by counting the same individual wells after 2-3 days. Bar graph shows full experimental results.

FIG. 19(b) is a graphical representation depicting the response of differentiated DRG neurons to LIF and NGF through embryonic development. DRG cells from embryos aged E14 to P2 were plated at 300-1000 cells/well and incubated in the presence or absence of growth factors and anti-NGF. The percent neuronal survival was determined by counting the same individual wells after 2-3 days. Line graph represents the time course of responsiveness to LIF and NGF alone and in combination. ##STR5##

FIG. 20 is a graphical representation showing the effect of NGF titration in the presence and absence of LIF on the survival of E15 DRG neurons. DRG cells were plated at 1000 cells/well in the presence of the indicated concentrations of NGF and in the presence (open square) or absence (closed diamond) of 10⁴. U/ml LIF. Neuronal survival was determined as in FIG. 3 after 3 days. ##STR6##

FIG. 21 is a photographic representation showing the detection of LIF mRNA in embryonic or neonatal tissue by PCR. First strand cDNA was synthesized from RNA extracted from tissues shown and used as a template for PCR using primers specific for LIF or GAP-DH, as described in Example 1. Numbers refer to the following tissues: 1, Whole spinal column 2, Dorsal root ganglia; 3, Spinal cord along; 4, Brain; 5, Limbs; 6, Skin; 7, Gut.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

The present invention involves the use of LIF or LIF and one or more neuron stimulating factors (also known as neurotrophic factors). More particularly, the present invention involves the use of LIF alone or in combination with NGF. By "LIF" and "NGF" as used herein is meant to include their naturally occurring, recombinant and synthetic forms. Such forms comprise the naturally occurring amino acid sequence of each molecule or any single or multiple amino acid substitutions, deletions and/or additions thereof including single or multiple substitutions, deletions and/or additions to any molecules associated with either molecule such as carbohydrate, lipid and/or peptide moieties. Accordingly, the terms "LIF" and "NGF" as used herein contemplate naturally occurring LIF and NGF and LIF-/NGF-like polypeptides and also encompass subunits, mutants, derivatives, homologues and analogues of LIF/NGF and which have LIF/NGF activity. Regardless of the LIF or NGF molecule used, however, the only requirement is that LIF alone or in combination with NGF assists in regulating neuron development and/or maintenance and/or regeneration in a mammal. In a preferred embodiment, the mammal is human and the LIF and NGF are of human origin or from a different mammal but which still have activity in a human. Hence, the source of LIF and NGF and the mammal to be treated may be homologous, i.e. from the same species of mammal (whether or not from the same individual) or may be heterologous, i.e. from different species of mammals. In some circumstances, the mammal to be treated may itself be used to isolate the LIF and/or NGF for use in the method of the present invention.

By "regulating neuron development, maintenance and regeneration" as used herein is meant to include stimulating, enhancing and/or maintaining the formation and/or survival of neurons in the central and peripheral nervous systems of a mammal. It also includes the ability of said factor to assist the regeneration of properties associated with neuronal function following damage caused by disease or trauma. It is also includes stimulating, enhancing, maintaining and/or regenerating those properties associated with neurons such as, but not limited to, neurotronsmitter type, receptor type and other features associated with this phenotype. In particular, LIF along and LIF and NGF in combination have been shown herein to be required for mature neurons to arise from neurofilament precursors in developing DRG. For convenience, reference in the specification and claims herein to "modulating neuron development" means stimulating, enhancing, maintaining and/or regenerating neurons.

In DRG isolated around the time of target innervation, NGF maintains 80% of the DRG neurons and LIF, the remaining 20%. Later, LIF maintains increasing numbers of neurons and around birth, both LIF and NGF each rescue more than 90% of the neurons. LIF mRNA is expressed in vivo first in the DRG and developing limbs and later it is more widespread, in the skin, gut, limbs and feet. Thus, without intending to limit the present invention to any hypothesis as to mode of action, LIF may first act as a differentiation agent for the precursor cells in conjunction with NGF, and later as a survival agent for sensory neurons.

In particular, LIF alone or in combination with NGF has been shown herein to induce, stimulate, enhance, maintain and/or regenerate (i.e. modulate) the differentiation of neural crest cells into fully mature neurons. This effect is titratable and occurs in the absence of proliferation of neuronal precursor cells. The effect of LIF alone or in combination with NGF also extends to the stimulation of the differentiation of precursor cells in embryonic dorsal root ganglia (DRG) into mature sensory neurons. The sensory neurons of the peripheral nervous system are derived from precursor cells in the embryonic neural crest. After crest migration, these precursor cells aggregate into the DRG and then differentiate into mature sensory neurons.

LIF alone or in combination with NGF also affects the central nervous system. The early steps in the development of the central nervous system from the embryonic precursor cells of the neural tube involves expansion of the precursor population and differentiation of these cells into mature neurons and glia. This phase is followed by a selective survival of neurons which have appropriately innervated the correct targets and is believed to be based on the limited availability of survival factors which are produced by the target cells.

It has been recently shown (9) that the fibroblast growth factors are involved in the expansion and differentiation phases of development of the embryonic brain and in addition it has also been shown that FGF can act as a survival agent for mature neurons. Work from Barde (5) indicates that the survival of a subset of CNS neurons, the retinal ganglion cells, is dependent on BDNF. However, little is known about other factors which are operative in the development of the embryonic brain and spinal cord.

Accordingly, it has now been surprisingly found that LIF acts as a differentiation/survival and/or regenerating agent for spinal cord neurons and enhances, stimulates and/or promotes spinal cord development and promotes neurite extension.

This method is particularly applicable to regulating spinal cord development and in treating a disease, injury and/or an abnormality to a nervous system. For example, the method of the present invention can be used in relation to the central and/or peripheral nervous system to treat one or more of Cerebral Palsy, trauma induced paralysis, vascular ischaemia associated with stroke, neuronal tumours, motorneurone disease, Parkinson's disease, Huntington's disease, Alzheimer's disease, multiple sclerosis, peripheral neuropathies associated with diabetes, heavy metal or alcohol toxicity, renal failure and/or infectious diseases such as herpes, rubella, measles, chicken pox, HIV and/or HTLV-1.

Another aspect of the invention relates to a method for enhancing, stimulating, maintaining and/or regenerating spinal cord development and spinal cord neuron number which comprises administering to said mammal an effective amount of LIF or LIF and NGF for a time and under conditions sufficient to effect an increase in spinal cord neuron number and spinal cord development.

Yet another aspect relates to a method enhancing, stimulating, maintaining and/or regenerating neurite extension from spinal cord and other central nervous system neurons and further relates to the central nervous system other than the spinal cord.

Still yet another aspect of the invention contemplates a method of treatment of disease and injury in both the central and peripheral nervous systems in a mammal, said disease or injury including but not limited to one or more of Cerebral Palsy, trauma induced paralysis, vascular ischaemia associated with stroke, neuronal tumours, motorneurone disease, Parkinson's disease, Huntington's disease, Alzheimer's disease, multiple sclerosis and peripheral neuropathies associated with diabetes, heavy metal or alcohol toxicity, renal failure and/or infectious diseases such as herpes, rubella, measles, chicken pox, HIV and/or HTLV-1 which comprises administering to said mammal an effective amount of LIF for a time and under conditions sufficient to ameliorate the disease or injury.

In all such methods of the present invention, the enhancing, stimulating, maintaining and/or regenerating of neurons is referred to as "regulating neuron development" or "modulating neuron development". Furthermore, use of the term "LIF" includes LIF-like polypeptides and derivatives thereof as discussed above. Additionally, when LIF and NGF are used, they may be simultaneously or sequentially administered and, when required, NGF. Although aspects of the present invention are exemplified by the combination of LIF and NGF, the invention extends to LIF in combination with one or more other neuron stimulating agents such as FGF, CNTF and/or BDNF. Accordingly, reference herein to "NGF" includes NGF-like polypeptides, derivatives thereof and to functionally equivalent molecules.

The effective amounts of LIF used in accordance with the present invention will be that required to regulate the neurons and will generally be, for each cytokine, from about 0.01 to about 10,000 microgram (μg) per kilogram (kg) of body weight and preferably 0.1 to 10,000 μg/kg, more preferably 1 to 1000 μg/kg and most preferably 10 to 500 μg/kg of body weight. However, depending on such factors as the disease treated, the treatment and the patient, more or less LIF may be used while still being within the scope of the present invention. Furthermore, it may be convenient to determine the effective amount of LIF in Units/ml or Units/kg. The definition of a Unit of LIF activity can be found in PCT/AU88/00093. For example, and not by way of limitation LIF may be used from 10 to 10⁸ U/ml. Administration may be per hour, per day, per week or per month or may be a single administration. Administration may also need to be continuous infusion.

In accordance with the present invention, LIF or LIF and NGF may be administered alone or in combination with one or more other neuron stimulating factors such as, but not limited to, FGF, CNTF and/or BDNF and/or other neurotrophic. In particular, LIF is administered with NGF. In "combination" means either the simultaneous addition of LIF and the one or more other factors (e.g. NGF) in the same composition or the sequential addition of the LIF and one or more other factors (e.g. NGF) where a first factor is given followed by a second factor. The exact order of addition and time between additions is best determined by the practicing physician and may depend on the patient and/or the treatment required. "Sequential administration" of LIF and NGF includes the single or multiple administration in any order of LIF and NGF with an appropriate time interval extending from seconds, minutes, hours, days or weeks. "Simultaneous administration" occurs when LIF and NGF are in the same pharmaceutical composition or a co-administered at the same time by separate, for example, injections or infusions or tablets.

Accordingly, the one or more other neuron stimulating factors may be given by simultaneous or sequential administration with LIF. The effective amount of other neuron stimulating factors will be from about 0.01 to about 10,000 μg/kg body weight, preferably 0.1 to 10,000 μg/kg, more preferably 1 to 1,000 μg/kg and most preferably 10 to 500 μg body weight. Again, administration may be a single dose or repeated per hour, per day, per week or per month. Administration may also be continuous infusion.

The route of administration is preferably by intramuscular or intravenous injection or using gene therapy although other routes of administration are possible such as by infusion, drip, intracerebral injection and/or implants.

Another aspect of this invention relates to administration of LIF to target tissue, or the precise location of the nerve so as to facilitate uptake by retrograde transport as outlined in Example 5.

The present invention is also directed to a pharmaceutical composition comprising LIF or LIF in combination with NGF and one or more pharmaceutically acceptable carriers and/or diluents. Such as composition is useful for regulating neuron development and/or maintenance in a mammal such as in enhancing, stimulating, maintaining and/or regenerating the formation and survival of neurons in the peripheral nervous system and/or enhancing, stimulating, maintaining and/or regenerating the formation and survival of sensory neurons in the central nervous system and/or enhancing, stimulating and/or maintaining the formation and survival of spinal cord neurons and/or spinal cord development. The subject composition is particularly useful is enhancing and/or stimulating neurofilament negative precursor cell development into DRG.

Preferably, the composition is suitable for administration into a human. In accordance with the present invention, the LIF and NGF used in the composition are as previously herein defined and includes, for example, LIF-like NGF-like polypeptides and mutants, derivatives, homologues and/or analogues including functional equivalents thereof. The LIF and NGF may be the same or different in terms of their mammalian source and whether they are naturally occurring, recombinant or synthetic. As with the method, the mammalian source of the LIF and NGF may be homologous or heterologous to the mammal being treated. The compositions of the present invention are also useful in treating the diseases, injuries and/or abnormalities of a nervous system as previously described. In another embodiment, the LIF and NGF may be in separate compartments in a two part pharmaceutical pack with instructions to combine the contents of both compartments before use. Furthermore, the compartments might be so arranged such that the mixing of both compartments occurs automatically before use. Such a pharmaceutical pack may also contain additional compartments for other neurotrophic factors and/or other components of the pharmaceutical composition required to be added before use.

The preparation of pharmaceutical compositions is well known in the art and reference can conveniently be made to Remington's Pharmaceutical Sciences, 16th ed., 1980, Mach Publishing Co., Edited by Osol et al.

Another aspect of the present invention is directed to the use of LIF or LIF and NGF including their derivatives for the manufacture of a medicament for enhancing, stimulating, maintaining and/or regenerating the formation and/or survival of neurons in the peripheral nervous system and/or enhancing, stimulating maintaining and/or regenerating the formation and/or survival of neurons in the central nervous system and/or enhancing, stimulating, maintaining and/or regenerating the formation and/or survival of spinal cord neurons and/or spinal cord development in a mammal. Preferably, the mammal is a human and the LIF and NGF used are as hereinbefore defined. The use in accordance with the present invention may also include the use of one or more other neuron stimulating factors such as FGF, CNTF and/or BNDF.

The present invention is further described by reference to the following non-limiting examples.

EXAMPLE 1 Materials and Methods

Preparation of Neural Crest Cells

CBA mouse embryos at embryonic day 9 (e9) were removed from the uterus and placed in a petri dish containing Hepes buffered Eagles Medium (HEM) with 1% (v/v) fetal bovine serum (FBS). The head and tail were removed using 26 gauge syringe needles with the aid of a dissecting microscope leaving a trunk segment with 8-12 somites each side of the neural tube. These trunk segments were placed in a fresh petri dish in HEM 1% (v/v) FBS and the somites and surrounding tissue were carefully removed from the neural tube using 26 gauge needles. One or two tubes were then placed in each well of a 24 well plate (Linbro) which had been previously coated with fibronectin (5 ug/ml). Dulbecco's modified Eagles' medium (DME) with 10% (v/v) FBS was then carefully run down the side of each well, so that it almost covered the bottom of the well. This enabled the neural tubes to associate with the fibronectin substratum and adhere. In particular experiments, the tubes were carefully removed after 24 hrs, leaving a layer of migratory neural crest cells. In other experiments the tubes were left in the wells so as not to disturb any of the integrated crest cells. Monomed medium (Commonwealth Serum Laboratories, Parkville, Victoria, Australia) with 10% (v/v) FBS and the specified growth factors was added to 1 ml to all cultures after 24 hrs. Cultures were incubated at 37° C. in 5% CO₂ /95% air.

Removal of Dorsal Root Ganglia (DRG)

Two day old neonatal mice were decapitated under aseptic conditions and placed into sterile petri dishes. The trunk was washed with a solution of 70% (v/v) ethanol in distilled water. A vertical incision through the skin was made using a sterile pair of 45° angle bladed scissors. All instruments used had previously been soaked for one hour before use in a solution of 70% (v/v) ethanol in distilled water.

A fine pair of iris scissors was used to make an incision through the dorsal aspect of the spinal column, which enabled the spinal cord to be removed using a pair of curved watchmaker forceps. This exposed the dorsal root ganglia and facilitated their removal. A sterile piece of gauze was used to swab the area around the ganglia so as to adsorb any blood and tissue fluid that obscured the view of the ganglia. Then using a pair of straight very fine tipped forceps each ganglia was carefully removed free of surrounding spinal tissue and placed into a petri dish in a small volume of N-2 hydroxyethylpiperasine-N-20 ethanesulfonic acid (HEPES) and buffered Eagles minimal essential medium (HEM). Approximately twenty ganglia were removed from each mouse.

DRG Cultures

The DRG dissected free of surrounding spinal tissue and placed in HEM, were finely chopped, then incubated in HEM, 0.025% (w/v) trypsin, 0.001% (w/v) DNase at 37° C. (12 min for E12-E14, 20 min for E15-E18 and 30 min for E19 and P2). FBS was added to 20% (v/v), the cells were centrifuged at 300 g for 5 min, washed twice in HEM, 0.01 (w/v) DNase and triturated through 19-25 gauge needles to obtain a single cell suspension. DRG cells were plated onto fibronectin coated (1.5 μg/ml) wells of HL-A plates (Nunc, II) at previously optimised cell members (3500 cells at E12, 1000 at E15, and 200 at E19 and P2). Two hrs after plating, no mature neurons were observed in the E12 cultures and an average of 110, 120 and 100 neurons had were present in the E15, E19 and P2 cultures, respectively. Cultures from E12 were fixed and stained for neurofilament after 5 days and neurofilament positive neurons counted using fluorescence microscopy. Neurons in later embryonic cultures (large, phase bright, round cells) were counted after 2 days.

Immunohistochemistry

For staining with particular antibodies neural tubes were plated onto glass coverslips in 24 well plates or onto plastic microscopic slides (Nunc, 2 chamber slides). For staining with antibodies to the 150 kd neurofilament (NF), the cells were first fixed in methanol at -20° C., washed 3 times in PBS and incubated for 30 min with an anti-neurofilament antibody (Chemicon, Temecula, Calif.) diluted 1:10 in HEM, 1% (v/v) FBS. The wells were then washed and incubated with a fluorescein isothiocyanate conjugated FITC sheep anti-rabbit antibody (Silenus) diluted 1:50 in PBS 1% (v/v) FBS, washed in PBS then in water, air dried and the cover slips mounted in 2.6% 1,4 Diazobicyclo (2,2,2) octane in PBS/glycerol (1:9) Merck, Aust. The immunofluorescent assay is described in International Patent Application No. PCT/AU91/00103. To stain for calcitonin gene related peptide (CGRP), cultures were fixed in paraformaldehyde (PFA), cleared with DMSO, washed with PBS, incubated with a rabbit anti-rat α-CGRP antibody (obtained from Dr G Olley, Monash University, Aust., and which shows 7% binding to B-CGRP, <0.01% binding to calcitonin, and negligible binding to substance P, Neurokinin A or Enkephalines by radio-immunoassay), washed and antibody binding detected using biotin conjugated second antibodies, a biotin-avidin-horseradish peroxidase complex (Vectastain ABC) and development with diamino-benzidine. To stain for tyrosine hydroxylase or choline acetyl transferase (ChAT), cultures were fixed in PFA (and picric acid for ChAT) incubated with a rabbit anti-tyrosine hydroxylase antibody (Eugene Tech. USA) or a rat antiserum prepared against porcine ChAT (which recognises ChAT in the PNS.(12), respectively and binding was detected with fluoresceinated second antibodies.

Thymidine Incorporation Experiments

To look for proliferating neural crest cells, ³ H-thymidine (Amersham, specific activity 103 Ci/mmol) was added to the cultures at 0.1 or 0.03 uCi/ml at the same time as growth factors were added or at corresponding times in control cultures. After 13 days some cultures were fixed in methanol, stained for neurofilament as described above and then dipped in Kodak NT-B2 emulsion and exposed for 2 weeks at 4° C. and the developed.

Isolation of Spinal Cord Cells

Embryos were obtained from embryonic day 10 (E10) mice. The heads were removed and the caudal part of the neural tube, or embryonic spinal cord, which forms a closed tube by E10, was removed together with the surrounding somites from the remainder of the embryo. The section of the cord used in all experiments extended from the otic vesicle to just below the developing hind limb. This tissue was subsequently incubated in Dispase II (Boehringer) in HEPES-buffered Eagle's medium (HEM) for 15 minutes at 4° C. and for 6 minutes at 37° C. The tissue was then transferred to HEM containing 1.0 (w/v) fetal bovine serum (FBS) and 0.001% (w/v) DNase and the spinal cord was dissected free of the surrounding ectoderm, somites and meninges, using the tissue plate created by Dispase incubation essentially as described previously for the preparation of the mesencephalic and telencephalic regions of the neural tube (9). Inspection at this stage revealed clean spinal cords free of contaminating mesoderm. These cords were plated directly for explant cultures into 24 well plates (Linbro). For preparation of dissociated cell suspensions, the spinal cords were then incubated at 37° C. in Hank's with 0.02% (w/v) EDTA, 10 mM Hepes, 0.025% (w/v) trypsin and 0.001% (w/v) DNase pH 7.6 for 12 minutes. The reaction was stopped by the addition of FBS, the cells were washed in Ca² +/Mg² + free Hank's and single cells were prepared by gently triturating the suspension. An average of 1.5×10⁵ cells were obtained from the dissection of each embryo.

Primary Culture of Dissociated Spinal Cord Cells

Spinal cord cells (5×10⁴) were plated onto 96 well plates (Linbro) coated with fibronectin (50 μg/ml) in Monomed medium and 0.05% FBS in a final volume of 100 μl. Except where otherwise stated, LIF (murine recombinant, specific activity+10⁸ U/mg) was used at a concentration of 10⁴ Units/ml. Assays were normally performed over 5 days after which the cultures began to deteriorate. Cell counts were performed after harvesting the cells with trypsin and triturating them. Process outgrowth was quantitated at day 5 by scoring the number of processes emanating from each discrete clump of cells. Numbers in all cases are the mean and standard deviation of sic determinations. Cells were also plated onto confluent, irradiated (4000 Rad) monolayers of Balb/c-3T3 cells on glass microscope slides in 24 well plates in Monomed medium and 0.05% (v/v) FBS, at a density of 5×10³ cells/well. At the specified periods of time, coverslips were fixed and stained for neurofilament as described below and the number of positively stained cells per slide was quantitated.

Assays

DRG cells were plated at the indicated cell number onto wells of HL-A plates (Nunc, Naperville, II) which has previously been coated with 50 μg/ml fibronectin (Boehringer-Mannheim, Federal Republic of Germany) for 1 hr. The cells were plated in Monomed medium, 10% v/v FBS, growth factors and anti-NGF antibodies where specified. LIF (E. coli derived murine recombinant, specific activity=10⁸ units/ml) was used at 10³ units/ml. For the preparation of recombinant LIF see International Patent Application No.PCT/AU88/00093. Mouse 2.5S NGF was used at 25 ng/ml and a monoclonal anti-2.5S mouse NGF at 500 ng/ml (both obtained from Boehringer-Mannheim). After 2 hr, the cultures were examined for the presence of morphologically mature neurons and neuron numbers were determined. E12 and E13 cultures were also stained for the presence of neurofilament (NF) as described below. For older cultures, the number of cells initially plated were as follows: E14-E15, 1000 cells; E16, 300 cells; E17E19, 200 cells; P2, 100 cells. To accurately determine the degree of survival in the E14-P2 DRG cultures, the number of neurons in each well were determined initially 2 hr after plating and then on successive days the duration of the experiment, which was 2-3 days. The percent survival, where 100% is the number of neurons after 2 hr, could thus be determined for each well. The numbers shown are the means and standard deviations of the percent survival for 6 wells. All experiments were performed at least twice.

Purification of Radioiodination of LIF and FGF

Recombinant LIF was produced in E. coli as a non-glycosylated protein. The purified species electrophoresed with an apparent molecular weight of 20,000 and an iso-electric point of greater than 9.0. Iodination of LIF was performed by the iodine monochloride method as previously described (18). Briefly, 6 μl of a 1 mg/ml solution of LIF in 40% (v/v) acetonitrile, 0.1% (v/v) trifluoroacetic acid and 0.02% (v/v) Tween 20 was iodinated by addition of 1 mCi Na¹²⁵ I (New England Nuclear, North Ryde, NSW, Australia), 40 μl of 200 mM sodium phosphate, 0.02% (v/v) Tween 20 at pH 7.4 (PBS) and, while vortex mixing, 5 μl of 200 μl of ICl in 2M NaCl. After 1 min at room temperature radioiodinated LIF (¹²⁵ I-LIF) was separated from unincorporated ¹²⁵ I by sequential gel filtration and cation-exchange chromatography. ¹²⁵ I-LIF produced in this manner retained full biological activity, was more than 99% precipitable with cold 20% (w/v) trichloracetic acid and greater than 90% of the radioactivity was capable of binding specifically to M1 cells (17). The specific radioactivity was 1.1×10⁶ cpm/pmole, as determined by self-displacement analyses. I¹²⁵ labelled aFGF was obtained as a gift from the RCC (Amersham). The specific activity of aFGF was 800 Ci/mM.

Binding Experiments and Autoradiography

Dorsal root ganglion cells were obtained from postnatal day 2 mice as described above and were cultured in 8 well microscope slides (Nunc) in monomed medium containing 10% (v/v) FCS, but no added growth factors overnight in a humidified incubator at 37° C. The slides were incubated on ice for 2 hours in 200 μl of Hepes buffered ROMI-1640 medium, supplemented with 10% (v/v) FCS, 20 μl of with or without 10 μg/ml of unlabelled LIF and from 5×10⁴ cpm of ¹²⁵ I-LIF in 20 μl of DME, 10% (v/v) FCS. The cells were washed three times with 300 μl of PBS and fixed in 10% (v/v) formalin in PBS for 2 hours and then rinsed in water. Slides were dipped in Kodak NTB2 photographic emulsion at 42 C. in a darkroom and allowed to dry. Slides were then sealed in a light-proof box containing Drierite and exposed for 2-8 weeks at 4 C. Prior to development, slides were warmed to room temperature and developed for 3 minutes in Kodak D19 developer (40 g/500 ml of water), washed for 1 minute in 0.5% (v/v) acetic acid in water and fixed in Agfa G333c X-ray fixer for 3 minutes. Slides with cytospin preparations were stained in 5% (v/v) filter Giemsa in water for 10 minutes, dried and mounted in Depex. DePex (BDH, Melbourne, Australia). Autoradiographs were examined at ×400, ×650, or ×1000 magnification and where necessary, grain counts were performed on 100 consecutive cells of each type and background counts, in general between 0-3 grains, were subtracted.

Retrograde Labelling Experiments

The sciatic nerves of newborn and adult Balb/C mice were ligated on one side using 6-0 prolene monofilament (Ethicon). The radioactive proteins were then injected either into the skin of the foot or intramuscularly into the centre of the gastronemus muscle. After appropriate times the animals were killed by ether overdose and the sciative nerves disected. The nerves were cut at the ligation and 2 mm pieces were taken immediately proximal and distal to the cut and counted directly.

Newborn and adult mice were injected in the footpad and kept for 16 hours. Ganglia from T13 to S1 were removed under a disecting microscope and the radioactivity estimated in the whole ganglion in a gamma counter. Selected ganglia or spinal cords with attached ganglia were dissected from the animals and fixed in 4% paraformaldehyde in PBS prior to being embedded in emulsion. Autoradiographs were developed 3-4 weeks later and ganglia and spinal cord examined for labelled cells.

Analysis of LIF expression

Tissues were dissected for RNA extraction as follows: from E11-E19 mice, dissections were in a petri dish containing PBS, using 27 gauge syringe needles; post-natal mice were dissected with small vannas scissors. Tissues dissected were feet (fore and hind), remainder of limb, tail, skin, gut, forbrain, mid- plus hind-brain, spinal cord (including meninges), DRG and whole spinal column (including spinal cord, meninges, DRG, vertebra and/or somites). Total RNA was extracted from tissues dissected from E12 and E15 mouse embryos using a guanidinium extraction procedure (Chomczynski and Sacchi, 1987). Poly A+ RNA was extracted from tissues dissected from E18 embryos and P2 mice using a proteinase K/SDS/oligo dT procedure (Gonda et al, 1982). First strand cDNA was synthesized as previously described (Allan et al, 1990) from at least 100 ng of RNA and used as a template for PCR. PCR reactions contained 200 μM dNTP, 1 μM primers, standard PCR buffer (Cetus) with Mg²⁺ at 2.5 mM, and 1.25 units of Taq polymerase (Cetus). Cycle conditions were 94° C. for 1.5 mins, 60° C. for 2 mins and 72° C. for 3 mins through 25 to 30 cycles depending on the amount of RNA. Primers for LIF and the glycolytic enzyme GAP-DH, which was used as a control for RNA quality and quantity, were as previously described (Allan et al, 1990). PCR reaction products were analysed by electrophoresis through 1.2% w/v agarose gels and then transfered to Zeta Probe membrane (Biorad) in 0.4M NaOH (Reed and Mann, 1985) for 2 to 6 hrs for Southern analysis. Filters were prehybrized and hybridized in 50% v/v formamide, 3×SSC, 5% w/v SDS, 10 mM sodium phosphate, 1% w/v skim milk powder at 42° C. DNA fragments (Allan et al, 1990) were radiolabelled with ³² P-α-dATP (Bresatec, Australia) by random priming to a specific activity of approx. 2×10⁹ cpm/μg and used in hybridizations at a concentration of 2×10⁷ cpm/ml. Following overnight 3×SSC, 5% w/v SDS, 10 mM sodium phosphate, 1% w/v skim milk hybridization, filters were washed to a final stringency of 0.2×SSC at 65° C. and autoradiographed (Kodak XAR5 film) with two intensifying screens at -70° C.

EXAMPLE 2 Effect of LIF on Neural Crest Cells and Sensory Neurons

To examine the effect of LIF on neural crest cells, neural tubes were dissected from the cervical and thoracic region of E9 CBA mice, plated onto fibronectin coated wells and neural crest cells were allowed to migrate onto the substratum for 24 hr, at which time the neural tubes were either removed or left in place and LIF was added to the cultures. After two days, round cells with uni- or bi-polar processes, resembling sensory neurons, appeared in the cultures. In the LIF treated cultures there were approximately 12 fold more of these cells than in controls by 6 days (FIG. 1) and they formed large clusters which increased in size up to 14 days (FIG. 2b). This was not dependent on the presence of the neural tube during the culture period although, in their absence, the absolute number of neuron-like cells was smaller (FIG. 1). These neuron-like cells stained positively with the Niss1 stain (8), (FIGS. 2a and b) and for 150 kD neurofilament (13), (FIGS. 2c and d). This staining showed fine processes emanating from the clusters (FIG. 2d), confirming their neuronal phenotype. While the effect of LIF was greatest when added at day 1, it was still apparent when added at day 7.

To characterise the phenotype of neurons generated in these cultures, they were stained for the expression of markers found in sensory and autonomic neurons. All the neurons in both LIF treated and control cultures contained immunoreactivity for CGRP (FIG. 2e), the most widely expressed peptide found in mammalian sensory neurons (14,15). Limited developmental studies suggest that this peptide is expressed quite early, at least in the chick (18). Immunoreactivity for substance P, a peptide also found in mammalian sensory neurons (14,15), but only in significant level postnatally (17), was also detected in a small proportion of processes in both LIF treated and control cultures. A small proportion (1-2%) of these neurons (both LIF treated and control) had tyrosine hydroxylase activity, a marker for catecholaminergic cells (FIG. 2f). However, none of the cells showed any immunoreactivity for ChAT, a marker for cholinergic cells.

These immunohistochemical findings, as well as the morphology of the neurons, suggest that they are in the sensory lineage. Previous work in aves has shown that at least a proportion of sensory neurons arise from non-dividing precursors in the neural crest (1-2). to investigate whether the neurons in the LIF treated cultures also arose from non-dividing precursors, ³ H-thymidine was added to the cultures concomitantly with LIF at days 1, 4 and 7 of culture. Autoradiographic analysis at day 13 showed that less than 0.2% of the neurons (2 in 1100 neurons counted) which arose in the LIF cultures incorporated ³ H-thymidine (FIGS. 3a and 3b) irrespective of time of addition. These observations show that the increase in neuron numbers does not result from stimulation of precursor division. Most of the non-neuronal cells in these cultures were labelled with ³ H-thymidine (FIGS. 3a and 3b) but the presence of LIF made no significant difference to the total proportion of labelled cells: when LIF was added on day 1, 80+/-18% of the cells were labelled compared to 78+/-12% on control cultures, whereas at day 7, 70+/-1% AND 70+/-6% of all cells were labelled in the presence and absence of LIF, respectively [n=3].

As LIF stimulates an increase in sensory-like neurons in neural crest cultures, it was anticipated to have similar activity on early embryonic DRG cultures. Thus, single cell suspensions were made from E12DRG, which contain a subpopulation of small, probably immature neurons as well as neuronal precursors (18) and were plated into wells of HL-A plates in the presence or absence of LIF. After 3 days clusters of neuron-like cells began to appear in the LIF treated cultures, but not in control cultures. After 5 days the cultures were stained for neurofilament and neurons were counted (FIG. 4A), showing that there were approximately 100 fold more neurons in the LIF treated cultures than in controls. Neurons were also present in cultures treated with nerve growth factor (NGF), but there were only about 10% of those seen in the LIF treated cultures after 5 days. Experiments on DRG cells isolated later in development (E15, E19, P2), showed a high proportion (80-100%) of neurons survived after 2 days in the presence of LIF (FIG. 4A).

Limited dilution experiments indicate that LIF acts directly on the neurons, as the rate of survival is not influenced by cell number (FIG. 4B). In addition, a LIF titration on the P2 DRG showed maximal activity over 10² U/ml and 50% activity at approximately 1.5 U/ml (FIG. 4C) which is comparable to that observed with other neurotrophic factors (4,5,6).

These results indicate that LIF can act throughout embryonic sensory neuron development in vitro. In neural crest cultures, it may act to stimulate neuronal differentiation and/or survival of the sensory precursors. Consistent with this, a subpopulation of neural crest cells was found to specifically bind ¹²⁵ I-LIF, indicating that they have LIF receptors. Others have implicated brain derived neurotrophic factor (BDNF) in the survival and/or differentiation of developing DRG cells. One possibility is that LIF, which is produced by mesoderm derived cells in vitro, may be produced in peripheral tissue in vivo and act in concert with the central nervous system derived BDNF in the development of the DRG.

The actions of LIF on the older DRG cultures show it to be a neurotrophic factor for sensory neuronsin vitro like NGF. LIF acts as a survival agent for postnatal and embryonic sensory neurons. The results herein indicate that LIF acts not only during the critical period of target innervation of the neurons but later as well. Thus, LIF may be exerting its effects throughout the development of sensory neurons and into adulthood.

EXAMPLE 3 Effect of LIF On Spinal Cord Neurons

1. LIF Stimulates Process Outgrowth from Embryonic Spinal Cord

In example 2, it was shown that LIF stimulates the development of sensory neurons in cultures of neural crest obtained from E9 mice embryos. In these cultures, the crest cells migrate out from the embryonic spinal cord onto the fibronectin substratum and the sensory neurons in the LIF cultures appear as clusters surrounding and at some distance from the spinal cord explant. It had been noted that LIF also influenced the appearance of the spinal cord where the explant had been left in the cultures increasing their apparent viability and process outgrowth. These experiments were repeated on spinal cord explants from E10 embryos, where most of the neural crest has already migrated away from the cord, but little neuronal differentiation occurred. In order to see if LIF might be acting on neurons or their precursors in the spinal cord, the serum was removed from our assays to slow down glial proliferation without necessarily affecting neuronal differentiation. As expected, in these cultures there was very little cell migration away from the explants, but there was still a great deal of process outgrowth in the LIF treated cultures (FIGS. 5a and 5b). The processes extended straight out from the explants, some in bundles and some as single processes, onto the substratum. There was also a limited degree of arborization of the processes. The stimulation of process outgrowth first became apparent at day 3 and increased up to a maximum at day 7.

These observations indicate that LIF may contribute to the process outgrowth and development of spinal cord neurons. To further test this, single cell suspensions of spinal cord cells were made and plated in the presence and absence of LIF to see if the effect could be observed in dissociated cultures. The advantage of these cultures is that an exact number of cells can be plated in each well as opposed to explants of different sizes and thus it may be easier to quantitate the effect of LIF.

When these cells were plated at fairly high cell density in both 96 well and HLA plates, they spontaneously aggregated into discrete clusters and processes emanated from these clusters and appeared to form bridges with other clusters (FIG. 6a). That these processes were definitely of neuronal origin was established by staining the cultures for neurofilament. All the processes in both LIF treated and control cultures stained positively with the anti-neurofilament antibody (FIG. 6a). In the presence of LIF far more of these processes were present than in controls (FIG. 6b). Almost all of the cell clusters in the LIF cultures emanated processes whereas most of the clusters in the controls had no processes. Further, there were generally more processes per cluster in the LIF cultures. This effect was observed by day 2 and was most obvious at day 5, by which time the number of processes in the control cultures had begun to diminish. At this time, the average number of processes in the LIF treated cultures was approximately 10 times that in the controls (FIG. 7).

EXAMPLE 4 LIF Stimulates an Increase in the Number of Neurons in Spinal Cord Cultures

One possibility to account for the stimulation of process outgrowth by LIF is that it stimulates the survival of precursors and/or differentiation of neurons in the spinal cord cultures. Initially, the total number of cells present in the cell cultures in the presence and absence of LIF was investigated. Cell counts were performed from 96 well plates after 3 and 5 days in vitro. As shown in FIG. 13, there was a small increase in total cell numbers in the presence of LIF. These data also show that there was little increase in cell number in either LIF or control culture, suggesting that little proliferation has occurred.

The increase in numbers in the LIF cultures might either be a small survival effect or an affect on a subpopulation of cells within the culture, i.e. the neurons. However, this method of analysis does not allow for the identification of neurons in the population. To determine if there were a significant effect on neuron number, as opposed to the entire population of cells which developed in the culture system, the E10 cells were plated at low density onto irradiated Balb/c-3T3 monolayers. Under these conditions, the cultures could be stained for neurofilament and individual neurons counted. By day 4 there were approximately 2 fold more neurons in the LIF treated cultures. In culture where 10,000 spinal cord cells were plated, 1920 neurons were observed in the LIF treated cultures compared to 998 in controls. In cultures where 2500 spinal cord cells were plated, there were 625 neurons in the LIF treated cultures compated to 343 in controls. By day 7 of culture there was still good survivial of neurons in the LIF cultures, whereas almost all of the neurons had died in the control cultures. These data suggest that LIF stimulates both the differentiation and survival of spinal cord neurons.

These experiments show that LIF stimulates process outgrowth from the undifferentiated trunk neural tube and from the embryonic spinal cord. Thus, LIF appears to be acting to stimulate the differentiation of spinal neurons which innervate the peripheral tissues of the body. The three major classes of neurons which do this are the lower motor neurons of the spinal cord and the preganglionic sympathetic and parasympathetic chains. As it is not yet possible to distinguish which of these classes LIF may be effecting, it can be speculated that the lower motor neurons would be good candidates given that the processes emanating from the tube are thick and extend long distances from the neural tube. Only lower motor neurons do this in vivo from the spinal cord. In addition, LIF has been found in the muscle which is the natural target of lower motor neuron innervation. A cohesive hypothesis is that LIF is the muscle derived target factor for these motor neurons. It stimulates them to extend processes toward the target and then acts as a survival factor for the neurons which have successfully innervated the muscle.

EXAMPLE 5 Binding and Retrograde Labelling Experiments

Example 2 shows that LIF supports the survival of the majority of sensory neurons form newborn dorsal root ganglia. This is evident even at very low cell numbers--single neurons could be supported--indicating the LIF probably acts directly on neurons and not via an accessory cell. To formally prove that sensory neurons express high affinity LIF receptors, binding studies on isolated sensory neurons were carried out in vitro. As shown in FIG. 8, greater than 50% of cells identified as neurons by their expression of neurofilament bound significant amounts of ¹²⁵ I-LIF, all of which was inhibited by the addition of cold LIF. Furthermore, there was negligible cold-inhibitable binding of ¹²⁵ I-LIF to non-neuronal cells in the culture.

These results show that mature sensory neurons do express high affinity receptors for LIF and that the accessory cells, such as Schwann cells, do not. This strongly argues for the direct neuronal action of LIF, which was predicted from the limiting dilution studies (Example 2) in which LIF supported the survival of very low numbers of sensory neurons. Studies with radiolabelled NGF have shown that both Schwann cells and neurons bind NGF in vitro, although it is not clear whether this reflects the steady-state in vivo situation. Apart from LIF, no other factors have been shown binding limited to the neuronal component.

The observed distribution of receptors fits well with results on in vitro survival that show that the vast majority of sensory neurons survive in the presence of LIF. The restricted distribution also suggests that LIF receptors may be limited to the neuronal lineage during sensory ganglia development.

Having demonstrated the presence of LIF receptors on sensory neurons in vitro, it was next investigated whether receptor mediated uptake of LIF would result in retrograde transport to the sensory neuron soma. Experiments using nerve ligation were carried out to determine if there was any retrograde transport of ¹²⁵ I-LIF by neurons with axons in the sciatic nerve. It was found that there was significant accumulation of radioactivity in the distal segment of the nerve after injection of ¹²⁵ I-LIF, into both the foot or leg (see Table 1). The time course of this accumulation suggested that it was due to retrograde transport and not to other mechanisms; furthermore there was no evidence of the distal accumulation of ¹²⁵ I-FGF after injection.

In order to examine more closely which neurons were involved in the retrograde transport of LIF, adult mice were again injected in the skin or muscle, but this time with the sciatic nerve intact. In those animals injected in the skin of the foot, after 16 hours there was a significant accumulation of radioactivity in the sensory ganglia centered on lumber ganglion 4 (L4; FIG. 9). There was a very much smaller accumulation of radioactivity in those animals injected in the muscle and this appeared to be more rostral (FIG. 9). Although FGF has been shown to support a range of neurons, including sensory neurons, there was no evidence of accumulation of ¹²⁵ I-FGF in the lumbar DRG or spinal cord.

                  TABLE 1                                                          ______________________________________                                         Injection of LIF into adult mice with ligated                                  sciatic nerve                                                                  Accumulation of LIF in nerve                                                   Femtomole/2 mm                                                                 Time after injection                                                                           Proximal stump                                                                            Distal stump                                        ______________________________________                                         Injection into the footpad                                                      7 hrs          0.144 ± .024                                                                           0.349 ± .084                                     16 hrs          0.170 ± .034                                                                           0.777 ± .108                                     24 hrs          0.060 ± .006                                                                           0.551 ± .045                                     Injection into the gastrocnemus muscle                                          7 hrs          0.109 ± .008                                                                           0.488 ± .128                                     16 hrs          0.137 ± .014                                                                           0.550 ± .135                                     24 hrs          0.069 ± .004                                                                           0.399 ± .138                                     ______________________________________                                    

The sciatic nerve was ligated in the mid high region of the adult mice and 1 μCi of ¹²⁵ I-LIF was injected either into the footpad of calf. After the various times the nerve was removed and 2 mm sections either side of the ligature were taken and radioactively measured in a gamma counter.

In newborn mice there was a greater accumulation of radioactivity for both the leg and foot injections. The skin injection again was centered on L4 (FIG. 10). The transport from the muscle injection was more widespread and may reflect the greater spread from the injection site in these small animals (FIG. 10). Again in both cases the accumulation of radioactivity in the L4 ganglia followed a time course consistent with retrograde transport.

Autoradiographic examination of histological sections through L4 ganglia from both adult and newborn animals injected with ¹²⁵ I-LIF into the footpad has revealed the presence of radioactive material in a subpopulation of neurons (FIGS. 11a(1)-a(2)). The number of neurons with significant number of grains is between 5-10% of the population (FIG. 12), again there is no evidence of radioactivity associated with non-neuronal cells (FIGS. 11b(1)-b(2)).

A major finding in accordance with this aspect of the present invention is that LIF is retrogradely transported in a manner resembling NGF. This re-enforces the view that the expression of LIF receptors is not an in vitro artefact and more importantly implicates LIF as a neurotrophic molecule for sensory neurons. As far as the present inventors know this is the only neurotrophic molecule, outside of NGF, that has been shown to be transported in such a manner, although there is evidence that FGF can be transported antero gradely in retinal ganglion cells. LIF, like NGF, does not appear to be transported antero gradely as there is no evidence of accumulation of the molecule in the spinal cord. It appears that LIF is not transported by motor neurons in the sciatic nerve nor does it appear to be transported in the sympathetic or parasympathetic nervous systems. This probably indicates that LIF is also capable of exerting a biological effect on the nervous system by directly binding to the cell surface and not undergoing receptor mediated transport. This would appear to be the primary mode of action of LIF on a wide variety of cells which include muscle, platelets, embryonal stem cells and some haemopoietic cell lines.

Although retrograde transport of NGF seems to be required for some of its biological action, no such evidence exists for LIF. The similarities of action of the two factors in the developing sensory neurons suggests that this process may be necessary to deliver a sufficient biological signal from the periphery to the cell soma. Such a suggestion appears too simplistic given the findings that NGF injected into the cell soma does not result in neuron survival. This suggests that it is the receptor-ligand complex that is important in signal delivery.

EXAMPLE 6 Interaction of LIF and NGF in the Early Stages of Sensory Neuron Differentiation

LIF stimulates the generation of sensory neurons from non-dividing precursors in cultures of mouse neural crest and immature (E12) DRG cultures (PCT/AU91/00103). These cultures were at high cell density; in the case of the neural crest cultures, the region in which the neurons arose was always over a confluent monolayer of neural crest cells and in the case of the E12 DRG cells, the development of neurons was dependent on the cell number initially plated. Very few morphologically mature neurons arose in cultures which had been plated at less than 3500 cells/well of an HL-A plate. Thus, it was possible that there was an endogenous activity required for the maturation of the precursor cells into mature neurons.

An NGF was added to the neural crest cultures alone and in the presence of LIF to look for any additive effect on the appearance of neurons. A marked synergistic effect between LIF and NGF was observed when the initial plating density in the DRG cultures was reduced (FIG. 14). In cultures of E12 or E13 DRG cells plated at 1000 cells/well, NGF alone had a significant effect on the number of morphologically mature neurons which appeared in the cultures, LIF alone had a much smaller effect, but in the presence of the 2 factors, there were 3-4 fold more neurons than in NGF alone plus the LIF alone cultures.

The observed synergy between LIF and NGF was further investigated by decreasing the number of E12 DRG cells plated to 300 cells/well and following the appearance of neurons in the cultures over time (FIG. 15). In cultures where only NGF was added, morphologically defined neurons first appeared after 1-2 days and there was no increase in neuron number after this time (FIG. 15). Fewer neurons appeared in LIF treated cultures and any effects of LIF were eliminated by the addition of NGF antibodies to the cultures. This indicates that the effects of LIF were dependent on the presence of NGF, endogenously produced in the cultures. The greatest effects were seen in cultures treated with LIF and NGF, where the neuron number increased up until 3 days to 3 times the levels seen in NGF cultures (FIG. 15).

Given that NGF's previous effects have been restricted to differentiated neurons and that there is no evidence that it has any activity on sensory precursors, it was possible that NGF was acting only on committed neurons in the E12 cultures, but that these neurons had not morphodifferentiated. To mark morphologically immature neurons, the cultures were stained for the presence of 150 kd neurofilament (NF), which has previously been shown to be expressed early in sensory neuron development (22). It was found that 2 hr after plating 300 E12 DRG cells into terasaki wells, an average of 15 cells stained positively for 150 kd NF and thus were probably immature sensory neurons (FIG. 16). In the presence of NGF this number initially increased slightly, but then did not increase over the rest of the assay period (FIG. 16). In the LIF+NGF cultures, the number increased throughout the culture period to approx 3 times the initial levels. In the LIF cultures, the number of these cells decreased through the assay period and in both control and in LIF plus anti-NGF cultures this drop in NF+ cell number was more marked, so that by the end of the culture period, there were only 1-2 NF+ cells/well.

FIG. 17 shows the effect of LIF, NGF and anti-NGF on the generation of neurons in neural crest cultures. As shown in FIG. 17, significant numbers of new NF+ neurons only arose in cultures treated with LIF and this was not influenced by the addition of exogeneous NGF or by removal of any endogenous NGF with antibody.

These observations support the concept that LIF acts independently to promote differentiation of NF- precursors into NF+ immature neurons.

As might be expected from the above results, the morphology of the NF+ neurons in either LIF or NGF treated cultures were quite different. The NF+ cells which appeared in the presence of LIF and anti-NGF had the appearance of small spherical bipolar neurons (FIG. 18A). Large NF+ neurons with extensive cytoplasm only appeared in the presence of NGF (FIG. 18B) and these were the dominant neuronal type under these conditions.

These data indicate that the early steps in the development of sensory neurons are independent of the presence of NGF, their continued maturation, as well as survival, appeared NGF dependent.

NGF alone is probably acting only on NF+ neurons in the culture to maintain their survival and is required for their maturation. LIF and NGF together result in significant differentiation of new neurons from their NF- precursors.

EXAMPLE 7 Effects of LIF and NGF on Sensory Neurons, Post Differentiation and at the time of innervation and Natural Neuron Death

By analogy with studies in the rat (19), most mouse DRG neurons are probably formed by E14. The newly formed neurons innervate their target tissue and go through a period of natural cell death, the control of which is presumably mediated through the availability of NGF. To look for LIF/NGF interactions at this stage, DRG were isolated from E14 through to postnatal day 2 (P2) mice, dispersed into single cells and cultured in the presence of LIF and NGF. As expected, between E14 and E15, NGF rescued between 65 and 80% of the plated neurons (FIGS. 19A and B). In the presence of LIF, a smaller proportion of neurons survived. This survival response was only slightly reduced in the presence of NGF antibodies. At E14-E15 the effects of LIF and NGF were at least additive and all of the neurons plated at these ages could be rescued in the presence of LIF+NGF. There were even slightly more neurons at E14 than the number initially plated (FIG. 19), presumably due to the presence of a small number of neuronal precursors still present at E14, which differentiated in the presence of LIF and NGF.

To determine whether there was any interaction between LIF and NGF at different concentrations and to confirm that the effects of LIF and NGF in rescuing all the neurons were additive at this developmental stage, and NGF titration in the presence and absence of LIF was undertaken with E15 DRG neurons (FIG. 20). This shows that the effects of LIF were approximately the same at all concentrations of NGF and were additive throughout. Thus, at this developmental stage the sensory neurons can be divided into two subgroups, one which responds to NGF and the other which responds to LIF.

EXAMPLE 8 Effect of LIF and NGF at Later Stages of Sensory Development

After innervation and the period of natural neuronal death, the neurons continue to die in culture without added factors, so they are presumably still dependent on factors for their survival. Assays conducted on DRG cells isolated after E16 showed a different response to the factors than before this period (FIGS. 19A and B). In the case of NGF, far fewer of the neurons could be rescued; at E17 and E18, only 25-35% of the neurons could be rescued by NGF. However, by E19 and postnatally, the number of NGF responsive neurons again increased to 70-80% of plated neurons.

The number of neurons which responded to LIF continued to increase from less than 20% at E16 to up to 90% postnatally and this response was not significantly reduced by NGF antibodies. In addition, the additivity between LIF and NGF decreased with development age, indicating that the fraction of sensory neurons responding to LIF and NGF were converging. By E19, there was almost complete overlap between the LIF and NGF responsive populations.

EXAMPLE 9 Expression of LIF during Embryonic Development

In order to examine the expression of LIF during the time of sensory development, tissues were isolated from mice at E9 through to P2 and RNA extracted to look for LIF transcripts. Previously, using standard RNA detection methods, such as Northern blotting, expression was not detected in any tissue from the adult mouse (23), suggesting that LIF mRNA is only produced at very low levels in vivo, if at all. Using the more sensitive polymerase chain reaction (PCR), however, the inventors and others have previously detected LIF mRNA in a number of tissues (eg references 24, 25 and 26), suggesting that constitutive LIF gene expression does occur, albeit at very low levels. Given this and the small amounts of tissue available from mouse embryos and neonates, PCR appeared to be the method of choice. The detection of transcripts by PCR were considered to be equatable with biological activity as a number of Northern blot negative, PCR positive cell lines and tissues secrete sufficient LIF protein to elicit a biological response (27). As shown in FIG. 21 using PCR, LIF mRNA was detected in a number of embryonic and neonatal tissues. When these experiments were repeated on several occasions, however, it was found that samples fell into one of three categories: consistently positive, randomly positive or consistently negative. While it is difficult to decide which results are biologically meaningful, particularly given the low level of expression required to elicit the paracrine action of many cytokines, it is believed that consistently positive results are likely to reflect constitutive gene expression while the significance of the stochastic results, which the inventors have shown to occur at the limit of sensitivity of the PCR (less than 30 molecules), is much less clear. Therefore, for the purpose of summarizing the data from several such experiments, consistenly positive results were scored as positive while randomly positive and consistently negative results were scored as negative. Using this criterion, the data from up to five independent experiments were summarized (Table 2). It was concluded, therefore, that LIF RNA is first expressed in whole spinal column and limbs from E12, then soon after in the DRG themselves. Later during embryogenesis, expression is maintained in these tissues and widens to include skin and gut. There is also consistent expression of LIF in early postnatal forebrain.

                  TABLE 2                                                          ______________________________________                                         SUMMARY OF LIF EXPRESSION DATA                                                         E11  E12      E13    E15    E18  P2                                    ______________________________________                                         Dorsal root      -        +    +      +    -                                   ganglia                                                                        Spinal column                                                                            -      +        +    +      +    +                                   Spinal cord                                                                              -      -        -    -      -    +                                   alone                                                                          Brain - fore +                                                                           -      -        -    -      -    +                                   mid                                                                            Brain - hind                                                                             -      -        -    -      -    -                                   Limbs (excluding +        +    +      +    +                                   feet)                                                                          Feet      -      -        -    +      +    -                                   Skin             -        -    +      +    -                                   Gut       -      -        -    +      +    +                                   ______________________________________                                    

A "+" indicates a consistently positive result for LIF in the PCR assay shown in FIG. 7; a "-" indicates either a consistently negative result or a randomly positive result. A blank indicates tissues at this embryonic age not assayed.

Those skilled in the art will appreciate that the invention described herein is susceptible to variations and modifications other than those specifically described. It is to be understood that the invention includes all such variations and modifications. The invention also includes all of the steps, features, compositions and compounds referred to or indicated in this specification, individually or collectively, and any and all combinations of any two or more of said steps or features.

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We claim:
 1. A method for promoting the functional regeneration of mammalian peripheral neurons comprising the administration of leukaemia inhibitory factor (LIF) for a time and under conditions sufficient to promote the regeneration of said neurons.
 2. A method for promoting the functional innervation of mammalian muscle comprising the administration of leukaemia inhibitory factor (LIF) for a time and under conditions sufficient to promote the innervation of said muscle.
 3. The method according to claims 1 or 2 wherein said neurons are myelinated.
 4. The method according to claims 1 or 2 wherein said mammalian neurons are human.
 5. The method according to claims 1 or 2 wherein said LIF is from a mouse, rat, human or livestock animal.
 6. The method according to claims 1 or 2 wherein said method further comprises the administration of an effective amount of at least one neuron stimulating factor selected from the group consisting of nerve growth factor (NGF), fibroblast growth factor (FGF), ciliary neurotrophic factor (CNTF) and brain-derived neurotrophic factor (BDNF).
 7. The method according to claim 1 or 2 wherein said LIF and the mammal to be treated belong to the same species.
 8. The method according to claims 1 or 2 wherein the amount of LIF administered to a mammal is from 0.01 to 10,000 μg/kg body weight.
 9. The method according to claim 8 wherein the amount of said LIF is from 1.0 to 1,000 μg/kg body weight.
 10. The method according to claim 9 wherein the amount of said LIF is from 10 to 500 μg/kg body weight.
 11. A method for rescuing the survival of mammalian peripheral neurons comprising the administration of LIF for a time and under conditions sufficient to reduce the incidence of neuronal death.
 12. The method according to claims 1, 2 or 11 wherein said neurons are motor neurons. 